Provider Demographics
NPI:1962140889
Name:DECHAMPLAIN, BRYCE MANN (MD)
Entity type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:MANN
Last Name:DECHAMPLAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:BRYCE
Other - Middle Name:ANNA
Other - Last Name:DECHAMPLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 QUARTERPATH
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9791
Mailing Address - Country:US
Mailing Address - Phone:843-325-3455
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:984-974-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program